(PS6-D87) Examining Differential Responses to the Take Care of Me Trial: a Follow-up Analysis

Given the high prevalence of comorbid alcohol misuse and emotional challenges among young adults, we developed a minimally guided, internet-based, integrated treatment called Take Care of Me. The study was an open-label two-arm RCT. Participants (N = 222) were randomized to one of two conditions: the treatment program (8 weeks consisting of 12 self-paced modules), or an online psychoeducational control condition. Intervention modules were based on principles of cognitive behavioral therapy (CBT) and motivational interviewing (MI). Although the treatment had an impact on several secondary outcomes (i.e., depression, hazardous drinking, psychological quality of life, confidence), effects were not observed for the primary outcome (i.e., total alcohol consumption) at the end of treatment (i.e., 8-weeks) or at follow-up (i.e., 24-weeks). Therefore, the goal of the current study was to examine heterogeneity in treatment responses. We conducted an exploratory latent class analysis to distinguish individuals based on pre-treatment risk and then used moderated regressions to examine differential treatment responses based on class membership. We found evidence for three distinct groups. Most participants fell in the “low severity” group (n = 123), followed by the “moderate severity” group (n = 57) who had a higher likelihood of endorsing a previous mental health diagnosis and treatment and higher symptom severity than the low group. The “high severity” group (n = 42) endorsed a family history of alcoholism, and the highest symptom severity and executive dysfunction. Moderated regressions revealed significant class differences in treatment responses. In the treatment condition, high severity (relative to low) participants reported higher alcohol consumption and hazardous drinking and lower quality of life at follow-up, whereas moderate severity (relative to low) individuals had lower alcohol consumption at follow-up, and lower hazardous drinking at end-of-treatment. No class differences were found for participants in the control group. Higher risk individuals in the treatment condition had poorer responses to the program overall. Take Care of Me is a promising intervention that, if evidence continues to mount, stands to improve the well-being of young adults on a larger scale using an accessible format (i.e., online, anonymous). Follow-up results suggest that tailoring said interventions to baseline severity may be important to examine in future research to ensure suitability and efficacy. Taken together, this can help inform how we respond to the mental health crisis facing young people in society.